Creative Litigation Fails Because Crime Does not Pay
Post 5109
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Prisoner Acting as His Own Lawyer Misses Prerequisite to His Suit
In this pro se prisoner case brought under 42 U.S.C. § 1983, United States Magistrate Judge Bradley W. Rath’s Report and Recommendation recommends that Defendants Sheriff John Ledbetter, Geneva Drummond, and VitalCore’s Motions for Summary Judgment be granted, that Plaintiff Monnie Villarreal’s Motion to Amend be denied as moot, and that the Court dismiss this case without prejudice for failure to exhaust administrative remedies.
In Monnie Villarreal v. Vitalcore, et al. No. 1:24-cv-99-HSO-BWR, United States District Court, S.D. Mississippi, (June 18, 2025) the District Judge adopted Magistrate Judge’s Report and Recommendation as the opinion of the Court.
BACKGROUND
Plaintiff Monnie Villarreal (“Plaintiff”) pled guilty to conspiracy to commit insurance fraud in the Circuit Court of Jackson County, Mississippi, and was sentenced to serve five years in the custody of the Mississippi Department of Corrections (“MDOC”). In 2024 Plaintiff violated the terms of his post-release supervision, and was ordered to serve the remainder of his sentence in MDOC custody, where he remained until his release in December 2024.
Plaintiff’s allegations stem from two incidents, an alleged denial of medical care and a purported failure to protect Plaintiff from violence at the hands of another inmate.
Plaintiff asserted that Defendants VitalCore and Nancy Unknown committed “attempted murder” by depriving him “of [a] proper dosage of insulin[,]” by not allowing him “to see a license[d] doctor[,]” and by forcing him to “live with high blood sugar.”
Plaintiff accused Sheriff Ledbetter and Drummond of “negligence and cruel punishment.” He asserts that he was assaulted by another inmate with a “broken wooden mop handle” on April 21, 2024, and that Drummond refused to answer his calls for help. Plaintiff filed three grievances during his incarceration at JCADC, all of which were submitted through the normal JCADC grievance system.
The Magistrate Judge recommended that Plaintiff’s claims be dismissed without prejudice for failure to exhaust administrative remedies under the Prison Litigation Reform Act. The Report and Recommendation highlighted that under the PLRA, “[e]xhaustion of administrative remedies through the prison grievance system is a prerequisite for lawsuits filed under § 1983.” Because Plaintiff had not filed any grievances related to the alleged incidents through the ARP, the Magistrate Judge found that Plaintiff had not exhausted his administrative remedies as to either of his claims.
DISCUSSION
Since exhaustion is a threshold issue that courts must address to determine whether litigation is being conducted in the right forum at the right time, judges may resolve factual disputes concerning exhaustion without the participation of a jury.
Plaintiff was not a pretrial detainee facing a new conviction but was instead a post-conviction inmate serving out the remainder of his sentence.
The JCADC Inmate Handbook required Plaintiff to use the JCADC grievance system and then the ARP grievance system before filing a lawsuit. The ARP was available to Plaintiff, and he has never maintained or argued that he used it to report the complained-of incidents.
CONCLUSION
It was ordered and adjudged that Defendants Sheriff John Ledbetter, Geneva Drummond, and VitalCore’s Motions for Summary Judgment were granted, and Plaintiff Monnie Villareal’s claims were dismissed without prejudice as to all Defendants for failure to exhaust administrative remedies.
ZALMA OPINION
Insurance fraud perpetrators are well known for their “Chutzpah” (Yiddish for unmitigated gall) and even when convicted and allowed to run free he violated the terms of his release and was incarcerated to serve the remainder of his sentence. He sued, in pro se, the Sheriff who ran the jail and others claiming many vicious actions against his person and health only to find he had failed to use the administrative remedies available to him so his suit was dismissed proving that no matter how creative his pleading crime does not pay.
(c) 2025 Barry Zalma & ClaimSchool, Inc.
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Concurrent Cause Doctrine Does Not Apply When all Causes are Excluded
Post 5119
Death by Drug Overdose is Excluded
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Southern Insurance Company Of Virginia v. Justin D. Mitchell, et al., No. 3:24-cv-00198, United States District Court, M.D. Tennessee, Nashville Division (October 10, 2024) Southern Insurance Company of Virginia sought a declaratory judgment regarding its duty to defend William Mitchell in a wrongful death case pending in California state court.
KEY POINTS
1. Motion for Judgment on the Pleadings: The Plaintiff moved for judgment on the pleadings, which was granted in part and denied in part.
2. Duty to Defend: The court found that the Plaintiff has no duty to defend William Mitchell in the California case due to a specific exclusion in the insurance policy.
3. Duty to Indemnify: The court could not determine at this stage whether the Plaintiff had a duty to ...
GEICO Sued Fraudulent Health Care Providers Under RICO and Settled with the Defendants Who Failed to Pay Settlement
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Post 5119
Default of Settlement Agreement Reduced to Judgment
In Government Employees Insurance Company, Geico Indemnity Company, Geico General Insurance Company, and Geico Casualty Company v. Dominic Emeka Onyema, M.D., DEO Medical Services, P.C., and Healthwise Medical Associates, P.C., No. 24-CV-5287 (PKC) (JAM), United States District Court, E.D. New York (July 9, 2025)
Plaintiffs Government Employees Insurance Company and other GEICO companies (“GEICO”) sued Defendants Dominic Emeka Onyema, M.D. (“Onyema”), et al (collectively, “Defendants”) alleging breach of a settlement agreement entered into by the parties to resolve a previous, fraud-related lawsuit (the “Settlement Agreement”). GEICO moved the court for default judgment against ...
ZIFL – Volume 29, Issue 14
Post 5118
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You can read the full 20 page issue of the July 15, 2025 issue at https://lnkd.in/giaSdH29
THE SOURCE FOR THE INSURANCE FRAUD PROFESSIONAL
This issue contains the following articles about insurance fraud:
The Historical Basis of Punitive Damages
It is axiomatic that when a claim is denied for fraud that the fraudster will sue for breach of contract and the tort of bad faith and seek punitive damages.
The award of punitive-type damages was common in early legal systems and was mentioned in religious law as early as the Book of Exodus. Punitive-type damages were provided for in Babylonian law nearly 4000 years ago in the Code of Hammurabi.
You can read this article and the full 20 page issue of the July 15, 2025 issue at https://zalma.com/blog/wp-content/uploads/2025/07/ZIFL-07-15-2025.pdf
Insurer Refuses to Submit to No Fault Insurance Fraud
...
Rulings on Motions Reduced the Issues to be Presented at Trial
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CASE OVERVIEW
In Richard Bernier v. State Farm Mutual Automobile Insurance Company, No. 4:24-cv-00002-GMS, USDC, D. Alaska (May 28, 2025) Richard Bernier made claim under the underinsured motorist (UIM) coverage provided in his State Farm policy, was not satisfied with State Farm's offer and sued. Both parties tried to win by filing motions for summary judgment.
FACTS
Bernier was involved in an auto accident on November 18, 2020, and sought the maximum available UIM coverage under his policy, which was $50,000. State Farm initially offered him $31,342.36, which did not include prejudgment interest or attorney fees.
Prior to trial Bernier had three remaining claims against State Farm:
1. negligent and reckless claims handling;
2. violation of covenant of good faith and fair dealing; and
3. award of punitive damages.
Both Bernier and State Farm dispositive motions before ...
ZIFL Volume 29, Issue 10
The Source for the Insurance Fraud Professional
See the full video at https://lnkd.in/gK_P4-BK and at https://lnkd.in/g2Q7BHBu, and at https://zalma.com/blog and at https://lnkd.in/gjyMWHff.
Zalma’s Insurance Fraud Letter (ZIFL) continues its 29th year of publication dedicated to those involved in reducing the effect of insurance fraud. ZIFL is published 24 times a year by ClaimSchool and is written by Barry Zalma. It is provided FREE to anyone who visits the site at http://zalma.com/zalmas-insurance-fraud-letter-2/ You can read the full issue of the May 15, 2025 issue at http://zalma.com/blog/wp-content/uploads/2025/05/ZIFL-05-15-2025.pdf
This issue contains the following articles about insurance fraud:
Health Care Fraud Trial Results in Murder for Hire of Witness
To Avoid Conviction for Insurance Fraud Defendants Murder Witness
In United States of America v. Louis Age, Jr.; Stanton Guillory; Louis Age, III; Ronald Wilson, Jr., No. 22-30656, United States Court of Appeals, Fifth Circuit (April 25, 2025) the Fifth Circuit dealt with the ...
Professional Health Care Services Exclusion Effective
Post 5073
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This opinion is the recommendation of a Magistrate Judge to the District Court Judge and involves Travelers Casualty Insurance Company and its duty to defend the New Mexico Bone and Joint Institute (NMBJI) and its physicians in a medical negligence lawsuit brought by Tervon Dorsey.
In Travelers Casualty Insurance Company Of America v. New Mexico Bone And Joint Institute, P.C.; American Foundation Of Lower Extremity Surgery And Research, Inc., a New Mexico Corporation; Riley Rampton, DPM; Loren K. Spencer, DPM; Tervon Dorsey, individually; Kimberly Dorsey, individually; and Kate Ferlic as Guardian Ad Litem for K.D. and J.D., minors, No. 2:24-cv-0027 MV/DLM, United States District Court, D. New Mexico (May 8, 2025) the Magistrate Judge Recommended:
Insurance Coverage Dispute:
Travelers issued a Commercial General Liability ...
